INTERNATIONAL RESEARCH

FORUM ON THE PHILIPPINES 2016

Anticipating Futures: Opportunities and Challenges for the
Philippines
21-22 November 2016
La Trobe University
Level 20, 360 Collins Street, Melbourne, VIC 300

Event Registration Form

Title
First Name
Last Name
Affiliation
Designation
Address Line 1
Address Line 2
Postal Code/Zip
Country
State/Province
Contact Number
Email Address

+code

number

Passport Number

IMPORTANT NOTE FOR THE PAPER PRESENTATION

Please be advised that you are given 15 minutes for your paper presentation and 5 minutes for
questions. A computer is provided for you. You are encouraged to be in your assigned room 10
minutes before your presentation. A finalized copy of the programme will be sent to your email
address in late October.

TITLE of PAPER

SOURCE OF FUNDING
Please indicate your source of funding by ticking the appropriate boxes. Tick all that apply.
Sponsorships from non FASTCO sources

Scholarships from non FASTCO sources

Personal

Others (please provide)

Do you wish to apply for bursaries?

NO
YES

If yes please explain (no more than 50 words):

Should you not be granted a bursary, do you still wish to attend?

NO
YES
N.B. Bursaries are usually in the form of a waiver of the registration fee.

REGISTRATION FEE PAYMENT METHODS

A$100 (professionals and international
participants)
For those applying for bursaries, tick here

A$20 (Australia-based students and

FASTCO members

You can pay the fee through bank transfer to the FASTCO bank account:
BANK:
ACCOUNT NAME:
BSB:
ACCOUNT NO:

Commonwealth Bank of Australia

Filipino Australian Student Council
063019
1091 1988

ASSISTANCE/ADVICE IN MAKING TRAVEL ARRANGEMENTS

Do you need assistance in making travel arrangements?
NO

YES

If yes please explain how we can help you (no

more than 50 words):

DIETARY REQUIREMENTS
No special dietary
requirement

Vegetarian Only

Any food allergies or restrictions that you

want us to know? (no more than 50 words):

Halal

DISABILITY OR ANY RELEVANT PHYSICAL LIMITATION

Should you require special assistance or facility as a result of your disability or physical limitation,
kindly let us know (no more than 50 words)
PRIVACY AND CONFIDENTIALITY
IMPORTANT NOTE FOR THE PAPER PRESENTATION
Please be advised that you are given 15 minutes for your paper presentation and 5 minutes for
questions. A computer is provided for you. You are encouraged to be in your assigned room 10
minutes before your presentation. A finalized copy of the programme will be sent to your email
address in late October.

Please note that the proceedings of the International Research Forum on the Philippines 2016 may be
recorded and photos may be taken for documentation purposes and media releases. Unless
otherwise indicated below, you are deemed to have consented on this regard (no more than 50
words).
Any copyright on the paper presented shall remain with the author.

I CERTIFY THAT THE ABOVE PIECES OF INFORMATION ARE TRUE, CORRECT, AND
COMPLETE TO THE BEST OF MY KNOWLEDGE AND BASED ON AUTHENTIC RECORDS.

YOUR SIGNATURE

DATE SIGNED

IMPORTANT NOTE FOR THE PAPER PRESENTATION

Please be advised that you are given 15 minutes for your paper presentation and 5 minutes for
questions. A computer is provided for you. You are encouraged to be in your assigned room 10
minutes before your presentation. A finalized copy of the programme will be sent to your email
address in late October.